Associate degree or higher in Nursing, or Bachelor's degree or higher in Social Work (BSW)
Current Registered Nurse (RN) license required for nursing candidates
One (1) or more years of Case Management leadership experience
Two (2) or more years of acute hospital-based case management experience (preferred)
Certification in case management (ACM or CCM) is preferred
Responsibilities
Support daily Case Management operations and initiatives focused on length of stay and readmissions.
Partner with physicians and advisors on utilization review and medical necessity.
Monitor and analyze key performance indicators to improve performance.
Collaborate with Revenue Cycle on medical necessity reviews and audits.
Ensure departmental practices align with regulations and standards.
Support Case Management staff through communication, education, and training.
Partner with the Director of Case Management to drive operational improvements.
Benefits
Opportunities for professional development and training.
Collaborative work environment with interdisciplinary teams.
Engagement in strategic initiatives to improve patient outcomes.
Supportive leadership focused on operational improvements.
Full Job Description
Overview
Join our team as a Case Management Manager in Westwood, NJ.
Responsibilities
The Manager of Case Management supports the strategic and daily operations of the hospital's Case Management department, including case management, social work, utilization review, and transitions of care. This role partners with hospital leadership, physicians, Revenue Cycle, and interdisciplinary teams to improve patient outcomes, optimize length of stay and readmissions, ensure regulatory compliance, and support efficient care delivery.
Support daily Case Management operations and initiatives focused on length of stay, readmissions, utilization management, and transitions of care.
Partner with physicians and internal and external physician advisors on utilization review, medical necessity, and appropriate level of care.
Monitor and analyze key performance indicators, including length of stay and readmission data, and implement workflows to improve performance.
Collaborate with Revenue Cycle and other departments on medical necessity reviews, audits, denials, and related improvement initiatives.
Ensure departmental practices align with applicable federal and state regulations, standards of practice, and organizational requirements.
Support Case Management staff through regular communication, education, workflow development, and training on regulatory requirements and emerging trends.
Partner with the Director of Case Management to drive operational improvements and achieve hospital and organizational goals.
Qualifications
Job Requirements:
Associate degree or higher in Nursing, or Bachelor's degree or higher in Social Work (BSW)
Current Registered Nurse (RN) license required for nursing candidates
One (1) or more years of Case Management leadership experience
Preferred Job Requirements:
Two (2) or more years of acute hospital-based case management experience
Certification in case management (ACM or CCM)
Rate of pay is determined based on experience and education and may include other pay components such as differentials and call pay based on role.
About Ardent Health Services
Ardent Health Services is a healthcare company that operates hospitals and other healthcare facilities in the United States. The company was founded in 1993 and is headquartered in Nashville, TN. Ardent Health Services is committed to providing high-quality healthcare services to patients and their families. The company's mission is to improve the health of the communities it serves by providing compassionate, personalized care.
